Monday, March 28, 2016

HIV Testing, Care & Treatment Experiences among the Steady Male Partners of Female Sex Workers Living with HIV in The Dominican Republic

Male steady partners of
female sex workers (FSW) living with human immunodeficiency virus (HIV)
represent a key population for treatment as prevention and/or pre-exposure
prophylaxis interventions. This study uses data collected from male steady
partners who were referred by FSW living with HIV participating in a
multi-level HIV prevention and care intervention in Santo Domingo, Dominican
Republic. We conducted a socio-behavioral survey and HIV testing with all men
(n = 64) and 16 in-depth interviews with a sub-sample to obtain more depth.
Thirty-five of the 64 participants were living with HIV; 27 were previously
diagnosed and 8 were diagnosed during our study. As a result, 45% of men were
members of sero-discordant sexual partnerships. Of men with no previous HIV
diagnosis (n = 37), 15 had never been tested for HIV and nine had not been
tested in the past two years. Ninety-three percent of men previously diagnosed
with HIV reported receiving HIV care in the past 6 months and 78% were taking
anti-retrovirals. Low HIV testing was partly due to men not feeling at risk for
HIV, despite having an HIV-infected partner. Additionally, a lack of tailored
care inhibited engagement in anti-retroviral treatment for those infected. HIV
testing was low, highlighting a need for test-and-treat strategies. Men not
living with HIV would benefit from regular testing and would be good candidates
for pre-exposure prophylaxis. While almost all men who had been diagnosed with
HIV were engaged in care and adherent to anti-retroviral therapy, future
research should assess whether they are achieving optimal HIV outcomes for
their health and prevention of ongoing transmission.